How we changed our minds about altruistic organ donors

Zell first learned about it in the Wall Street Journal. Shane read a Vox article. Jan heard someone being interviewed on the radio.

Zell, Shane and Jan are all nondirected kidney donors – people who gave a kidney to a stranger, having first discovered that this was even possible through the news media.

Nondirected kidney donation (NKD) is pretty rare: around 60 donations take place in the UK and 300 in the US each year. That means very few of us learn about it through someone we know – we’re far more likely to discover NKD and thus form our first impressions of it from a news item, or maybe a fictionalised drama.

The vast majority of NKD donors have a positive experience, and they tend to believe that more people would donate if they just knew more about it. So, often they’re happy to speak to journalists – not to boast, but because they know the resulting coverage could spark other donations. (Although not many go as far as Zell Kravinsky did: he invited a local reporter to actually attend his operation.)

What’s interesting is that the nature of media coverage seems to have shifted quite significantly. This was one of my findings from research I did for my MA Philanthropic Studies dissertation, in which I compared English-language print media coverage of NKD in 2004 and 2024.

This matters, because whether an issue is presented positively or negatively can influence how people feel about that cause – and whether they support it or not. For example, researchers found that a ranking of “America’s worst charities” caused people to feel sceptical about the entire nonprofit sector, even several years later.

Evolution                              

In 2004, NKD was only happening in a handful of countries worldwide. Most people were baffled by what could motivate someone to make such a sacrifice, and they suspected ulterior motives – perhaps money had exchanged hands, or donors were seeking glory – or they concluded that donors were freaks, or mentally unwell. Public reactions were at times hostile: “Some called me a stupid bitch”, one would-be donor told a reporter. Another told of getting “abuse” for offering a kidney: “I had messages saying: ‘Who do you think you are?’” News headlines were also unsympathetic at times. One donor, widely suspected of lying about his motives, felt the media “wanted to crucify me”. One newspaper asked if Zell Kravinsky was a “heartless lunatic”.

By 2024, the world of NKD had changed considerably. Doctors increasingly accepted that some people just genuinely want to help someone in need, and could feel reassured by a growing body of research into the motives and experiences of altruistic donors. In some countries, specialist charities had been formed to promote NKD. And the need for living kidney donations had continued to rise. Right now, 7,000 people in the UK need a kidney transplant. Experts agree that deceased donations will never meet this need.

All this means that donors are far less likely to be seen as freaks. One Canadian donor I spoke to recently – who has actually given both a kidney and part of his liver to a stranger – says he has never had a negative response to his story. That surprised me a little, given that “do-gooders” tend to be disliked (a phenomenon known as do-gooder derogation). Meanwhile, the news headlines I studied were almost entirely positive by 2024. Journalists and editors are now far, far more likely to describe NKD as heroic – even aspirational: one referred to “the dream of being a donor” while another claimed that “living donation offers the chance to become superheroes”.

A conundrum

Sometimes, the skew towards positive coverage made me uneasy. Cases of donors and recipients forming life-changing friendships are rare in reality, but – because these really are incredible stories – they get lots of media attention. That could raise false expectations among potential donors, who on the whole have very limited or no contact with recipients. And often the physical risks of surgery (though they are indeed quite low) were barely mentioned.

There’s another interesting issue. Donors insist they’re just ordinary people – “anyone could do it” is a common refrain, even when the headline contradicts this (“extraordinary”, “heroic”, “fairy godmother”, etc.). Paradoxically, the more we celebrate these heroes, the more unexceptional they become. In other words, the more commonplace NKD becomes, the less newsworthy it is. This is already happening: one patient’s plea on Facebook prompted 60 strangers to contact transplant coordinators, according to a 2024 UK news article. That seems pretty remarkable to me – yet it was only briefly noted before the journalist moved on.

This evolution presents a real conundrum for anyone wanting to get more media coverage for this cause: how do you pitch NKD as both ordinary enough for anyone to do it, but extraordinary enough to deserve media attention? It will be fascinating to see how the media landscape evolves in the coming years.  

Photo by Fatih Maraşlıoğlu on Pexels